AMA Journal of Ethics®

Illuminating the art of medicine

May 2012 Contents

When It's Not Your Patient

Ethics Poll

Under which of the following conditions do you think it is ethically permissible for a physician to treat family members? Check all that apply.

In emergency situations only, where no other physician is available.

When the symptoms are urgent, but not emergent [e.g., high fever in an infant] and it is impossible or inconvenient to get to the patient's regular physician for a matter of hours.

When the symptoms are minor [e.g., a cold, poison ivy].

For any medical condition not related to sexual activity, reproduction, or the illegal use of drugs.

For any symptoms that are physical and not psychiatric.

For chronic, routine conditions (physical and psychiatric) that the family member has been treated for in the past by other physicians.

For prescribing or renewal of any medication except controlled substances (e.g., opioids).

When the physician's treatment of the family member is kept confidential.

Under no conditions.

A commentor quoted in this issue of Virtual Mentor predicts that the future role of the generalist physician is likely to be supervising physician assistants and advanced nurse practitioners who deliver most of the primary care, while the physician provides care only for patients with complex illnesses who are hospitalized. Considering patients' access to care and the training and competence of the care givers, do you think this change would improve primary care?

Yes.

No.

Don't know.

Have you ever sought a second opinion and then switched permanently to the second-opinion physician from the physician you were initially seeing?